Liver transplantation using controlled donation after cardiac death donors: An analysis of a large single‐center experience

The use of donation after cardiac death (DCD) donors may provide a valuable source of organs for liver transplantation. Concerns regarding primary nonfunction (PNF) and intrahepatic biliary stricture (IHBSs) have limited the enthusiasm for their use. A retrospective analysis of 1436 consecutive dece...

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Bibliographic Details
Published in:	Liver transplantation Vol. 15; no. 9; pp. 1028 - 1035
Main Authors:	Grewal, Hani P., Willingham, Darrin L., Nguyen, Justin, Hewitt, Winston R., Taner, Bucin C., Cornell, Danielle, Rosser, Barry G., Keaveny, Andrew P., Aranda‐Michel, Jamie, Satyanarayana, Raj, Harnois, Denise, Dickson, Rolland C., Kramer, David J., Hughes, Christopher B.
Format:	Journal Article
Language:	English
Published:	Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-09-2009
Subjects:	Adolescent Adult Age Factors Aged Aged, 80 and over Brain Death Child Death Graft Rejection - etiology Graft Rejection - mortality Graft Rejection - surgery Graft Survival Humans Kaplan-Meier Estimate Liver Transplantation - adverse effects Liver Transplantation - mortality Middle Aged Reoperation Retrospective Studies Risk Assessment Risk Factors Time Factors Tissue and Organ Procurement Tissue Donors Transplantation, Homologous Treatment Outcome Young Adult
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Summary:	The use of donation after cardiac death (DCD) donors may provide a valuable source of organs for liver transplantation. Concerns regarding primary nonfunction (PNF) and intrahepatic biliary stricture (IHBSs) have limited the enthusiasm for their use. A retrospective analysis of 1436 consecutive deceased donor liver transplants performed between December 1998 and October 2006 was conducted. These included 108 DCD liver transplants, which were compared to 1328 transplants performed with organs from donors meeting the criteria for donation after brain death (DBD). The median follow‐up was 48 months. The 1‐, 3‐, and 5‐year patient survival and graft survival for DCD donors were 91.5%, 88.1%, and 88.1% and 79.3%, 74.5%, and 71.0%, respectively. The 1‐, 3‐, and 5‐year patient survival and graft survival for DBD donors were 87.3%, 81.1%, and 77.2% and 81.6%, 74.7%, and 69.1%, respectively. Patient survival and graft survival were not significantly different between DCD donors less than 60 years old, DCD donors greater than 60 years old, and DBD donors. Causes of graft loss included IHBSs (n = 9), PNF (n = 4), recurrent hepatitis C virus (n = 4), hepatic artery thrombosis (n = 1), rejection (n = 2), and patient death (n = 13). Contrary to previously published data, excellent long‐term patient survival and graft survival can be obtained with DCD allografts, and in our experience, they are equivalent to those obtained from DBD allografts. Liver Transpl 15: 1028–1035, 2009. © 2009 AASLD.
Bibliography:	Telephone: 904‐956‐3261; FAX: 904‐956‐3359 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1527-6465 1527-6473
DOI:	10.1002/lt.21811